In this prospective epidemiological study, 650 women who represented the entire spectrum of drinking practices were interviewed in their fourth and seventh months of pregnancy. These women and their offspring were assessed at delivery and at 8, 18 and 36 months. The next phase of this study will assess growth, morphological anomalies, cognitive development, behavior, motor skills, and neuropsychological performance of the children at age 6. We have demonstrated a relationship between prenatal alcohol exposure and growth, morphological abnormalities, and cognitive development of the offspring through the age of 3. Continuation of this project will enable us to determine whether the observed relationship between prenatal alcohol use and smaller size and slower rate of growth is maintained as the children mature, and how environmental factors affect this process. It will allow us to evaluate further the effect of prenatal exposure on cognitive development as the children acquire new and more complex skills. The long term impact of prenatal alcohol exposure on the growth and development of the offspring is unknown. We do not know whether prenatal exposure effects in young children persist, resolve, or are expressed differently at older ages. In the absence of this information, we cannot counsel parents or intervene to identify and treat the problems of school- aged children who have been exposed to alcohol prenatally.